减少娩儿失血的五缓慢步骤(精).docVIP

NUMPAGES 11頁的第 PAGE 4頁 English first, simplified Chinese later 先英語, 后簡體漢字 Steps in lowering blood loss There are 5 steps. First is to deliver the head and body of the baby in stages, meaning to reduce the uterine volume in stages. That is, using as much time as necessary to remove the amniotic fluid, and using more time than you normally use to delivery the fetal head. The rationale is to give the upper segment a short rest during volume reduction, enabling it to make strong contraction and retraction to close the injured blood vessels. Second is to repair the uterine incision as quickly as possible. Normally the anterior wall of the uterine lower segment has no opening. What the lower segment needs is to repair the uterine incision quickly. The slow steps of this operation technique is to imitate the lengthy labour process of a vaginal delivery. When a patient is in labour, 1. the amniotic fluid takes several hours to leave the uterus, 2. the fetal head takes several hours to descend to the vulva, 3. descent of the fetal head from the cervix through the vulva takes almost an hour or more, 4.when the fetal head has come through the vulva, allow 10 or more seconds for the air passages to be cleared before delivering the rest of the baby, 5.let the placenta wait for the obvious signal that it has been separated and descended to the top of the vagina before pushing it out. This usually means a wait of several minutes after the second stage. Obviously, if these 5 stages of action are transplanted to a cesarean delivery, first is to make a small uterine incision at the right place, and to take 20-90 seconds to remove all of the amniotic fluid, second is to use 4 fingers or a Murless extractor slowly to lift up the head to the incision level, then, together using 30 or more second to pull up the upper uterine flap, third is give 20 or more seconds to lift the head out of the incisions without lacerating the incision, and allowing the incisions squeeze out flu